Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Iran J Med Sci. 2023 Mar;48(2):219-226. doi: 10.30476/ijms.2022.92813.2419.
The novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is primarily a respiratory virus. However, an increasing number of neurologic complications associated with this virus have been reported, e.g., transverse myelitis (TM). We report a case of a 39-year-old man admitted to Namazi Hospital affiliated with Shiraz University of Medical Sciences, Shiraz, Iran. In December 2020, the patient was infected with Coronavirus Disease 2019 (COVID-19). During hospitalization, the patient suffered from sudden onset of paraplegia, and urinary retention, and had a T6-T7 sensory level. TM was diagnosed and an extensive workup was performed to rule out other etiologies. Eventually, para-infectious TM associated with COVID-19 was concluded. The patient received pulse methylprednisolone therapy of 1 g/day for 10 consecutive days followed by seven sessions of plasma exchange without a favorable response. The patient then underwent regular physical rehabilitation and tapering oral administration of prednisolone 1 mg/Kg. As a result, weakness in the lower extremities improved slightly after six months. Overall, we suspect a correlation between COVID-19 and TM, however, further studies are required to substantiate the association.
新型严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)主要是一种呼吸道病毒。然而,越来越多的与该病毒相关的神经系统并发症已被报道,例如横贯性脊髓炎(TM)。我们报告了一例 39 岁的男子,他在伊朗设拉子 Shiraz 大学医学院附属 Namazi 医院住院。2020 年 12 月,该患者感染了 2019 年冠状病毒病(COVID-19)。住院期间,患者突然出现截瘫和尿潴留,并伴有 T6-T7 感觉水平。诊断为 TM,并进行了广泛的检查以排除其他病因。最终,诊断为与 COVID-19 相关的副感染性 TM。患者接受了为期 10 天、每天 1g 的脉冲甲基强的松龙治疗,随后进行了 7 次血浆置换,但无明显疗效。然后,患者接受常规的物理康复治疗和逐渐减少口服泼尼松龙 1mg/Kg。6 个月后,下肢无力略有改善。总的来说,我们怀疑 COVID-19 和 TM 之间存在关联,但需要进一步的研究来证实这种关联。